Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 31 , ISSUE 2 ( April-June, 2020 ) > List of Articles

Original Article

Efficacy of Ultrasound-guided Autologous Blood Injection in Chronic Lateral Epicondylitis: A Randomized Controlled Trial

Utpalendu Debnath, N Romi Singh, Jotin S Yengkhom, Kaustav Basuthakur, Ranjan K Lisham, Obit Jerang

Keywords : Autologous blood injection, Lateral epicondylitis, Musculoskeletal ultrasonography, Patient-rated tennis elbow evaluation, Tendinopathy

Citation Information : Debnath U, Romi Singh N, Yengkhom JS, Basuthakur K, Lisham RK, Jerang O. Efficacy of Ultrasound-guided Autologous Blood Injection in Chronic Lateral Epicondylitis: A Randomized Controlled Trial. Indian J Phy Med Rehab 2020; 31 (2):31-37.

DOI: 10.5005/jp-journals-10066-0078

License: CC BY-NC 4.0

Published Online: 25-06-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Tendinopathy is common in professional athletes as well as in sedentary people. It occurs in 30–50% of all sports-related injuries. Injection of autologous blood has been reported beneficial for the treatment of tendinopathy. It is hypothesized that transforming growth factor-β and basic fibroblast growth factor carried in the blood will act as humoral mediators to induce the healing cascade. Musculoskeletal ultrasound can document the pathology before the injection and accurately identify the site for injection. It also helps in monitoring tendon healing. Materials and methods: This randomized controlled trial was carried out after obtaining permission from Research Ethics Board between September 2016 and August 2018 in the Department of Physical Medicine and Rehabilitation (PMR), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. Ninety-two patients with lateral epicondylitis were included in this study. The independent variables considered were age, sex, occupation, duration, and side of affection. The intervention group received autologous blood injection (ABI), whereas the control group received Inj. triamcinolone acetonide 40 mg under musculoskeletal ultrasound guidance. Results and observations: Out of 92 patients recruited, 54 patients were females (58.69%) and 38 were males (41.33%). The intervention group consisted of 26 females and 20 males with a mean age group of 47.20 ± 10.06 years while the control group consisted of 28 females and 18 males with a mean age group of 46.20 ± 8.79 years. There was a significant improvement in the visual analog scale (VAS) and patient-rated tennis elbow evaluation (PRTEE) score in the ABI group compared to the control group in 6 months follow-up. There was also a significant improvement in neovascular, echotexture grading, and tendon size in the ABI group compared to the control group in 6 months follow-up. Conclusion: The study showed that a single injection of ultrasound-guided ABI is significantly more effective in reducing pain and disability in resistant lateral epicondylitis at 6 months as compared to steroid injection. This study also confirmed that there was significant improvement of ultrasound parameters in the ABI group compared to the steroid injection group and may be considered as an alternative to surgery in resistant lateral epicondylitis.


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